Researchers see progress on some disease fronts

You rarely hear good health news coming out of Africa, but malaria rates are dropping in several countries on the continent, thanks in part to increased political momentum in the U.S.

By Kristine CraneStaff writer

You rarely hear good health news coming out of Africa, but malaria rates are dropping in several countries on the continent, thanks in part to increased political momentum in the U.S.

Timothy Ziemer is the coordinator of the Presidential Malaria Initiative, and explained this success story at the University of Florida’s Emerging Pathogens Institute’s annual research day on Thursday.

Since 2000, more than 3.3 million malaria deaths have been averted, over half of those in children under the age of five, Ziemer said. This is largely because of mosquito prevention efforts such as 400 million bed nets delivered to sub-Saharan Africa since 2008 and indoor spraying that has affected 75 million people, he said.

In Rwanda, malaria mortality rates have dropped 75 percent, due to bed nets and indoor spraying, as well as increased diagnoses. The country, Ziemer said, has a goal of zero malaria deaths by 2017.

In Tanzania, malaria morbidity has dropped 45 percent, and in Zanzibar, less than 1 percent of kids test positive for the virus.

And yet, despite this stream of successes, a glaring problem has developed for the past several years in Southeast Asia, another part of the globe where malaria has long been present.

That problem is drug resistance.

“The development of resistance to the one drug we have is very concerning,” said Dr. Glenn Morris, the director of Emerging Pathogens Institute and a UF professor of medicine.

Morris said the dynamism between the changing nature of pathogens and scientists at the helm of trying to control them is the never-ending struggle that defines the work at the institute.

“We will always have infectious diseases with us,” Morris said.

And malaria, despite worldwide declines in incidence, still defines that struggle.

ACTs, which stands for artemisinin-based combination therapies, have been showing resistance in Cambodia, Burma and Vietnam for several years now, said Dr. Christopher Plowe, a malaria expert and professor of medicine at the University of Maryland School of Medicine, who spoke at research day.

Plowe added that they have made headway in nailing at least one of the genetic mutations responsible for drug resistance, but complicating matters is that different genetic mutations may exist in different countries.

With the goal of global malaria eradication high on politicians’ list of priorities, the only sure-fire way to get there will likely be a vaccine, experts at the research day agreed.

So far, a phase three clinical trial of the RTS,S vaccine has shown a 30 percent success rate in preventing clinical malaria and a 26 percent success rate in preventing severe malaria. Plowe called these results “at least a partial success story.”

In the meantime, prevention and treatment efforts continue.

Plowe said the history of malaria eradication in the U.S and southern Europe has largely been a story of economic development. In the 1880s, most of the U.S. east of the Mississippi River had significant malaria cases; southern Italy was likewise plagued. But as access to medication improved and more people were able to afford homes with windows, malaria rates dropped.

In Italy, the eradication of malaria also became an issue coupled to workers’ rights, Plowe said.

While a quick end to the endemic poverty and strife in certain parts of Africa and Asia might not be realistic, increased funding has made headway in eradication. The Global Fund, which funds initiatives against TB, AIDs and malaria, spent $100 million on malaria eradication in 2003, which by 2009 had jumped to $2.9 billion.

The U.S. government has also been a major source of anti-malaria funding. President George W. Bush started the Presidential Malaria Initiative in 2005, and President Barack Obama has continued the political commitment to the initiative, while increasing funding for it, Ziemer said.

Fighting malaria is part of the president’s larger goal of improving maternal and childhood health, he added.

Contact Kristine Crane at 338-3119, or kristine.crane@gvillesun.com.

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